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001-es BibID:BIBFORM044266
Első szerző:Husby, Steffen
Cím:European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Guidelines for the Diagnosis of Coeliac Disease / Husby, S., Koletzko, S., Korponay-Szabó, I. R., Mearin, M. L., Phillips, A., Shamir, R., Troncone, R., Giersiepen, K., Branski, D., Catassi, C., Lelgeman, M., Mäki, M., Ribes-Koninckx, C., Ventura, A., Zimmer, K. P., the ESPGHAN Working Group on Coeliac Disease Diagnosis, the ESPGHAN Gastroenterology Committee
Dátum:2012
ISSN:0277-2116
Megjegyzések:OBJECTIVE: Diagnostic criteria for coeliac disease (CD) from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) were published in 1990. Since then, the autoantigen in CD, tissue transglutaminase, has been identified; the perception of CD has changed from that of a rather uncommon enteropathy to a common multiorgan disease strongly dependent on the haplotypes human leukocyte antigen (HLA)-DQ2 and HLA-DQ8; and CD-specific antibody tests have improved.METHODS:A panel of 17 experts defined CD and developed new diagnostic criteria based on the Delphi process. Two groups of patients were defined with different diagnostic approaches to diagnose CD: children with symptoms suggestive of CD (group 1) and asymptomatic children at increased risk for CD (group 2). The 2004 National Institutes of Health/Agency for Healthcare Research and Quality report and a systematic literature search on antibody tests for CD in paediatric patients covering the years 2004 to 2009 was the basis for the evidence-based recommendations on CD-specific antibody testing.RESULTS:In group 1, the diagnosis of CD is based on symptoms, positive serology, and histology that is consistent with CD. If immunoglobulin A anti-tissue transglutaminase type 2 antibody titers are high (>10 times the upper limit of normal), then the option is to diagnose CD without duodenal biopsies by applying a strict protocol with further laboratory tests. In group 2, the diagnosis of CD is based on positive serology and histology. HLA-DQ2 and HLA-DQ8 testing is valuable because CD is unlikely if both haplotypes are negative.CONCLUSIONS:The aim of the new guidelines was to achieve a high diagnostic accuracy and to reduce the burden for patients and their families. The performance of these guidelines in clinical practice should be evaluated prospectively.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
celiac disease
Megjelenés:Journal Of Pediatric Gastroenterology And Nutrition 54 : 1 (2012), p. 136-160. -
További szerzők:Koletzko, Sibylle Korponay-Szabó Ilma (1959-) (gyermekgyógyász) Mearin, Maria Luisa Phillips, A. Shamir, R. Troncone, Riccardo Giersiepen, Klaus Branski, D. Catassi, Carlo Lelgemann, Monika Mäki, Markku Ribes-Koninckx, Carmen Ventura, Alessandro Zimmer, Klaus-Peter the ESPGHAN Working Group on Coeliac Disease Diagnosis the ESPGHAN Gastroenterology Committee
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001-es BibID:BIBFORM044265
Első szerző:Ribes-Koninckx, Carmen
Cím:Coeliac Disease Diagnosis : ESPGHAN 1990 Criteria or Need For a Change? Results of a Questionnaire / C. Ribes-Koninckx, M. L. Mearin, I. R. Korponay-Szabó, R. Shamir, S. Husby, A. Ventura, D. Branski, C. Catassi, S. Koletzko, M. Mäki, R. Troncone, K. P. Zimmer, the ESPGHAN Working Group on Coeliac Disease Diagnosis
Dátum:2012
ISSN:0277-2116
Megjegyzések:INTRODUCTION:: A revision of criteria for diagnosing celiac disease (CD) is currently being conducted by ESPGHAN. In parallel, we have performed a survey aimed to evaluate current practices for CD among pediatric gastroenterologists (PG) and to learn their views on the need for modification of current criteria for CD diagnosis. METHODS:: Questionnaires were distributed to experienced PG (ESPGHAN members) via internet. RESULTS:: Overall, 95 valid questionnaires were available for analysis, pertaining to 28 different countries, with the majority of responders treating CD patients for more than 15 years. Only about 12% of the responders comply with current criteria, noncompliance being related mainly to the challenge policy.About 90 % request a revision and modification of the current criteria. 44% want to omit the SBB in symptomatic children with positive anti-tissue Transglutaminase (tTG) IgA or endomysial (EMA) IgA antibodies, specially if they are DQ2/DQ8 positive. For silent cases detected by screening with convincingly positive tTG IgA or EMA IgA, about 30% consider that no small bowel biopsy (SBB) should be required in selected cases. Adding HLA typing in the diagnostic work up was asked for by 42% of the responders. As for gluten challenge a new policy is advocated restricting its obligation to cases whenever the diagnosis is doubtful or unclear. CONCLUSIONS:: Based on these opinions, revision of the ESPGHAN criteria for diagnosing CD is urgently needed.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
celiac disease
Megjelenés:Journal of Pediatric Gastroenterology and Nutrition. - 54 : 1 (2012), p. 15-19. -
További szerzők:Mearin, Maria Luisa Korponay-Szabó Ilma (1959-) (gyermekgyógyász) Shamir, R. Husby, Steffen Ventura, Alessandro Branski, D. Catassi, Carlo Koletzko, Sibylle Mäki, Markku Troncone, Riccardo Zimmer, Klaus-Peter the ESPGHAN Working Group on Coeliac Disease Diagnosis
Internet cím:DOI
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